Diffuse steatonecrosis - presenting as an obscure abdominal mass - a diagnostic dilemma

Authors

  • Binay Kumar Department of Pathology, Government Medical College, Haldwani, Nainital, Uttarakhand, India
  • Upasna Chachra Department of Pathology, Government Medical College, Haldwani, Nainital, Uttarakhand, India
  • . Bhuvan Department of General Surgery, Government Medical College, Haldwani, Nainital, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20170187

Keywords:

Pancreas, Steatonecrosis, Submucosa, Xanthogranulomatous reaction

Abstract

Diffuse steatonecrosis secondary to acute / gangrenous pancreatitis presenting as vague abdominal mass is difficult to diagnose and requires special method / techniques for demonstration of fatty acid crystalloids. We report a case of acute abdomen with palpable lump. On emergency exploratory laprotomy a large thick jumbled up omental mass was revealed adhered to parietal wall along with complete pancreatic necrosis. Biopsy show diffuse fat necrosis of pericolic fat, omentum / mesentry with involvement of gut submucosa and birefringent saponified fatty acid crystalloids were demonstrated. Steatonecrosis may cause diagnostic dilemma and should be considered as differential diagnosis in appropriate clinical setting.

References

Kusum D, Semlani S, Deshpande. Migration of steatonecrosis in pancreatitis. Indian J Pathol Microbiol. 2006;49(4):546-7.

Keen CE, Buk SJA, Brady K, Levison DA. Fat necrosis presenting as obscure abdominal mass: Birefringent saponified saponified fatty acid crystalloids as a clue to diagnosis. J Clin Pathol. 1994;47:1028-31.

Agarwal S, Nelson JE, Stevens SR, Gilliam AC. Diffuse erythema as an unusual presentation of pancraetic fat necrosis. J Cutan Med Surg. 2002;6(1):16-8.

Cannon JR, Pitha JN, Everett MA. subcutaneous fat necrosis in pancreatitis. J Cutan Pathol. 1979;6(6):501-6.

Saag KG, Niemann TH, Warner CA, Naides SJ. subcutaneous pancreatic fat necrosis associated with acute arthritis. J Rheumatol. 1992;19(4):630-2.

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Published

2017-01-23

How to Cite

Kumar, B., Chachra, U., & Bhuvan, . (2017). Diffuse steatonecrosis - presenting as an obscure abdominal mass - a diagnostic dilemma. International Journal of Research in Medical Sciences, 5(2), 734–736. https://doi.org/10.18203/2320-6012.ijrms20170187

Issue

Section

Case Reports